Thirty-two asylum seekers rescued by the Sri Lankan navy say they went without food for 21 days and were forced to throw dozens of dead overboard after their wooden vessel failed at sea. The survivors, who identified themselves as Muslims from near the Burma-Bangladesh border, told local officials that they set out to seek refuge in Indonesia or Australia, but instead spent two months languishing on the water. By the time they were plucked from the sea, they’d thrown 98 bodies to the waves.

The nightmare of shipwreck may sound like a relic of another time, but what happened off the coast of Sri Lanka this week is alarmingly commonplace. The U.N. estimates that at least 13,000 people fled the borderlands between Burma and Bangladesh by boat in 2012. Of them, 485 are known to have drowned. This deadly tide looks unlikely to recede: at least 1,800 refugees washed up in Thailand in January 2013 alone.

Why risk the waves? Many of the asylum seekers are ethnic Rohingya Muslims, a group the U.N. identifies as among the most isolated and oppressed in the world. Though many Rohingya have lived along the Bay of Bengal for generations, some 800,000 are stateless, sandwiched between Burma and Bangladesh, welcome in neither. The Burmese government has never recognized them as part of the patchwork nation’s 135 indigenous ethnic groups and, over the years, has restricted their right to live, work and marry. In June 2012, the reported rape of a Buddhist woman in Arakan (Rakhine) state sparked a wave of communal violence that left at least 78 dead and tens of thousands displaced. An August report by Human Rights Watch said Burmese security forces did little to stop the violence and committed acts of murder, rape and forced displacement.

In the months since that violence, the conflict has lingered on, with many ethnic Rohingya left to wait indefinitely in squalid camps. In a dispatch published yesterday, TIME contributor Jason Motlagh, outlined how conditions have deteriorated:

Eight months on, pockets of Rohingya that remain in rural Arakan state are in serious trouble. Doctors Without Borders (MSF) announced in early February that its field teams continued to face hostile threats from Arakanese leaders and state forces that forced them to cut back medical care. Moreover, the aid agency warned of a brewing “humanitarian emergency” in the heavily restricted camps around Sittwe. Burmese officials claim the camps are necessary to shield the Rohingya population from further harm, but MSF says that acute malnutrition, skin infections and other ailments caused by poor sanitation are on the rise, especially among those uprooted by a second spasm of violence in October and now live on the margins of established camps.

With few options for work, and limited prospects for peace, more and more people are fleeing, Motlagh writes:

Faced with stagnant conditions inside the camps and insecurity everywhere else, greater numbers are taking their chances on the open sea. Mohdi Kasim, a prominent Rohingya community leader living in one of the camps, described how his neighbor, a veteran police officer, showed up at his door earlier in the morning in tears asking for money to help cover his boat fare. Both of his sons had already left. According to Idriss, 35, a Rohingya boat builder with gold rings on his fingers, two to three vessels are leaving the Sittwe area every night, often packed with over 100 passengers. (He declines to disclose his full name for fear of persecution.) “We tell the people it’s not safe, but they insist on going,” he says. “They are suffering so much here.” (Read the full story: “Pushed From Burma, Stateless Rohingya Flee by Boat“)

Until that pain eases, desperate people will take to the water, and the death toll will rise.